Which test is used to assess PCL pathology?

Which test is used to assess PCL pathology?

• A. Posterior Drawer
• B. Anterior Drawer
• C. Lachman
• D. Pivot Shift

Answer: (A)

Testing the posterior cruciate ligament involves the posterior drawer exam. The PCL is the main restraint to backward (posterior) movement of the tibia relative to the femur, especially when the knee is bent to about 90 degrees. In this test, the knee is flexed to 90 degrees and the tibia is pushed backward. If the PCL is intact, the tibia moves back only a little and stops with a solid end feel. If the PCL is damaged, there is increased posterior tibial translation and a softer or absent end feel, sometimes with a noticeable posterior sag. This makes the posterior drawer the best choice for assessing PCL pathology. The other tests target the ACL and its rotational instability (anterior drawer for forward tibial translation, Lachman for ACL integrity, Pivot Shift for anterolateral rotational instability), which is why they don’t assess the PCL.

Testing the posterior cruciate ligament involves the posterior drawer exam. The PCL is the main restraint to backward (posterior) movement of the tibia relative to the femur, especially when the knee is bent to about 90 degrees. In this test, the knee is flexed to 90 degrees and the tibia is pushed backward. If the PCL is intact, the tibia moves back only a little and stops with a solid end feel. If the PCL is damaged, there is increased posterior tibial translation and a softer or absent end feel, sometimes with a noticeable posterior sag. This makes the posterior drawer the best choice for assessing PCL pathology. The other tests target the ACL and its rotational instability (anterior drawer for forward tibial translation, Lachman for ACL integrity, Pivot Shift for anterolateral rotational instability), which is why they don’t assess the PCL.